Prediction of Hypotension During Neuraxial Anesthesia in Patients with Pregnancy-Induced Hypertension Through Subclavian Vein Collapsibility Index

Objective:To explore and evaluate the predictive value of subclavian vein collapsibility index(SCV-CI)on hypotension during neuraxial anesthesia in patients with pregnancy-induced hypertension(PIH).Methods:Pregnant women with PIH who underwent elective cesarean section in our hospital from January to July 2021 were selected as the research subjects.Patients who experienced hypotension during anesthesia were included into the hypotension group,whereas patients who had a normal blood pressure during anesthesia were included in the normotensive group.The SCV-CI was then calculated for three respiratory cycles,the average value was taken as the base value,and the patient was monitored for another 20 minutes.The blood pressure,heart rate,blood oxygen saturation,and SCV-CI of the patients were measured,and the incidence of maternal nausea and vomiting and cord blood gas were recorded.Then,a correlation analysis was conducted on the relationship between subclavian vein collapsibility index and hypotension.A receiver operating characteristic curve was drawn to seek the threshold value of subclavian vein collapsibility index for post-anesthesia hypotension.Results:There was no significant difference in systolic blood pressure(SBP),diastolic blood pressure(DBP),and heart rate(HR)between the two groups before anesthesia(P>0.05).After anesthesia,the above indexes(SBP,103.25±12.48 mmHg;DBP,58.94±7.46 mmHg;and HR,52.96±6.48 beats/min)were significantly lower than those of the normal blood pressure group,and the difference was statistically significant(P<0.05).In comparison,the SCV-CI in the hypotension group was 35.82±4.93%greater than that in the normal blood pressure group(23.85±5.27%),and the incidence of nausea and vomiting in the hypotension group(40.0%)was significantly higher than that in the normotensive group(10.53%),and the difference was statistically significant(P<0.05).The area under the curve of SCV-CI prediction against hypotension in patients with PIH under neuraxial anesthesia was 0.825(95%CI:0.762-0.893,P<0.001),the cut-off value was 25.68%,the predictive sensitivity was 92.68%,and the specificity was 81.24%.Conclusion:SCV-CI has a good predictive value for the occurrence of hypotension in patients with PIH during neuraxial anesthesia.

Causal associations between gastroesophageal reflux disease and essential hypertension: A bidirectional Mendelian randomization study

BACKGROUND Clinical studies have reported that patients with gastroesophageal reflux disease(GERD)have a higher prevalence of hypertension.AIM To performed a bidirectional Mendelian randomization(MR)analysis to investi-gate the causal link between GERD and essential hypertension.METHODS Eligible single nucleotide polymorphisms(SNPs)were selected,and weighted median,inverse variance weighted(IVW)as well as MR egger(MR-Egger)re-gression were used to examine the potential causal association between GERD and hypertension.The MR-Pleiotropy RESidual Sum and Outlier analysis was used to detect and attempt to reduce horizontal pleiotropy by removing outliers SNPs.The MR-Egger intercept test,Cochran’s Q test and“leave-one-out”sen-sitivity analysis were performed to evaluate the horizontal pleiotropy,heterogen-eities,and stability of single instrumental variable.RESULTS IVW analysis exhibited an increased risk of hypertension(OR=1.46,95%CI:1.33-1.59,P=2.14E-16)in GERD patients.And the same result was obtained in replication practice(OR=1.002,95%CI:1.0008-1.003,P=0.000498).Meanwhile,the IVW analysis showed an increased risk of systolic blood pressure(β=0.78,95%CI:0.11-1.44,P=0.021)and hypertensive heart disease(OR=1.68,95%CI:1.36-2.08,P=0.0000016)in GERD patients.Moreover,we found an decreased risk of Barrett's esophagus(OR=0.91,95%CI:0.83-0.99,P=0.043)in essential hypertension patients.CONCLUSION We found that GERD would increase the risk of essential hypertension,which provided a novel prevent and therapeutic perspectives of essential hypertension.

Effect of a comprehensive geriatric assessment nursing intervention model on older patients with diabetes and hypertension

BACKGROUND The Comprehensive Geriatric Assessment(CGA)was introduced late in China and is primarily used for investigating and evaluating health problems in older adults in outpatient and community settings.However,there are few reports on its application in hospitalized patients,especially older patients with diabetes and hypertension.AIM To explore the nursing effect of CGA in hospitalized older patients with diabetes and hypertension.METHODS We performed a retrospective single-center analysis of patients with comorbid diabetes mellitus and hypertension who were hospitalized and treated in the Jiangyin Hospital of Traditional Chinese Medicine between September 2020 and June 2022.Among the 80 patients included,40 received CGA nursing interventions(study group),while the remaining 40 received routine nursing care(control group).The study group's comprehensive approach included creating personalized CGA profiles,multidisciplinary assessments,and targeted inter-ventions in areas,such as nutrition,medication adherence,exercise,and mental health.However,the control group received standard nursing care,including general and medical history collection,fall prevention measures,and regular patient monitoring.After 6 months of nursing care implementation,we evaluated the effectiveness of the interventions,including assessments of blood glucose levels fasting blood glucose,2-h postprandial blood glucose,and glycated hemoglobin,type A1c(HbA1c);blood pressure indicators such as diastolic blood pressure(DBP)and systolic blood pressure(SBP);quality of life as measured by the 36-item Short Form Survey(SF-36)questionnaire;and treatment adherence.RESULTS After 6 months,the nursing outcomes indicated that patients who underwent CGA nursing interventions experienced a significant decrease in blood glucose indicators,such as fasting blood glucose,2-h postprandial blood glucose,and HbA1c,as well as blood pressure indicators,including DBP and SBP,compared with the control group(P<0.05).Quality of life assessments,including physical health,emotion,physical function,overall health,and mental health,showed marked improvements compared to the control group(P<0.05).In the study group,38 patients adhered to the clinical treatment requirements,whereas only 32 in the control group adhered to the clinical treatment requirements.The probability of treatment adherence among patients receiving CGA nursing interventions was higher than that among patients receiving standard care(95%vs 80%,P<0.05).CONCLUSION The CGA nursing intervention significantly improved glycemic control,blood pressure management,and quality of life in hospitalized older patients with diabetes and hypertension,compared to routine care.

Alterations in the gut microbiome after transjugular intrahepatic portosystemic shunt in patients with hepatitis B virus-related portal hypertension

BACKGROUND Gut microbiota(GM)affects the progression and response to treatment in liver diseases.The GM composition is diverse and associated with different etiologies of liver diseases.Notably,alterations in GM alterations are observed in patients with portal hypertension(PH)secondary to cirrhosis,with hepatitis B virus(HBV)infection being a major cause of cirrhosis in China.Thus,understanding the role of GM alterations in patients with HBV infection-related PH is essential.AIM To evaluate GM alterations in patients with HBV-related PH after transjugular intrahepatic portosystemic shunt(TIPS)placement.METHODS This was a prospective,observational clinical study.There were 30 patients(with a 100%technical success rate)recruited in the present study.Patients with esophagogastric variceal bleeding due to HBV infection-associated PH who underwent TIPS were enrolled.Stool samples were obtained before and one month after TIPS treatment,and GM was analyzed using 16S ribosomal RNA amplicon sequencing.RESULTS One month after TIPS placement,8 patients developed hepatic encephalopathy(HE)and were assigned to the HE group;the other 22 patients were assigned to the non-HE group.There was no substantial disparity in the abundance of GM at the phylum level between the two groups,regardless of TIPS treatment(all,P>0.05).However,following TIPS placement,the following results were observed:(1)The abundance of Haemophilus and Eggerthella increased,whereas that of Anaerostipes,Dialister,Butyricicoccus,and Oscillospira declined in the HE group;(2)The richness of Eggerthella,Streptococcus,and Bilophila increased,whereas that of Roseburia and Ruminococcus decreased in the non-HE group;and(3)Members from the pathogenic genus Morganella appeared in the HE group but not in the non-HE group.CONCLUSION Intestinal microbiota-related synergism may predict the risk of HE following TIPS placement in patients with HBVrelated PH.Prophylactic microbiome therapies may be useful for preventing and treating HE after TIPS placement.

Cognitive impairment in cerebral small vessel disease induced by hypertension

Hypertension is a primary risk factor for the progression of cognitive impairment caused by cerebral small vessel disease,the most common cerebrovascular disease.Howeve r,the causal relationship between hypertension and cerebral small vessel disease remains unclear.Hypertension has substantial negative impacts on brain health and is recognized as a risk factor for cerebrovascular disease.Chronic hypertension and lifestyle factors are associated with risks for stro ke and dementia,and cerebral small vessel disease can cause dementia and stroke.Hypertension is the main driver of cerebral small vessel disease,which changes the structure and function of cerebral vessels via various mechanisms and leads to lacunar infarction,leukoaraiosis,white matter lesions,and intracerebral hemorrhage,ultimately res ulting in cognitive decline and demonstrating that the brain is the to rget organ of hypertension.This review updates our understanding of the pathogenesis of hypertensioninduced cerebral small vessel disease and the res ulting changes in brain structure and function and declines in cognitive ability.We also discuss drugs to treat cerebral small vessel disease and cognitive impairment.

Risk factors for hypertension in pregnant women in Indonesia:A cross-sectional study

Objective:To determine the risk factors for hypertension in pregnant women,which is a significant cause of maternal and newborn morbidity and mortality in Indonesia.Methods:This was a cross-sectional study used secondary data from the 2018 Indonesian Basic Health Research.Pregnant women aged 15-54 years in the second and third trimesters were eligible.The history of hypertension in pregnant women was the dependent variable.The independent variables consisted of the demographic characteristics of pregnant women including pregnancy age,gestational age,education,occupation,place of residence,and region of residence.This study used multivariate logistic regression to determine the risk factors for hypertension in pregnant women in Indonesia.Results:.Among 6479 respondents included in this study,11(7.0%)had a history of diabetes mellitus(DM)and hypertension compared to pregnant women who did not have a history of DM(0.1%).The dominant risk factors for hypertension in pregnant women in Indonesia include maternal age above 35 years(OR 3.67,95%CI 2.54-5.32),third-trimester pregnancy(OR 2.40,95%CI 1.72-3.35),primigravida(OR 1.78,95%CI 1.19-2.68),excessive consumption of salty foods(OR 1.44,95%CI 1.03-2.03),and diabetes mellitus(OR 10.20,95%CI 3.04-32.23).Conclusions:Great efforts must be made to increase public awareness about the dangers of hypertension in pregnant women through early diagnosis and treatment,education on sodium intake,and appropriate care for pregnant women with DM.

The Burden of Undiagnosed Hypertension and Associated Risk Factors among Adults in a Rural Community in Imo Sate, South-East Nigeria

Background: Cardiovascular diseases are the leading cause of death globally and hypertension is a major contributor to this burden. Many people with hypertension have poorly controlled blood pressure and up to half of the adults with hypertension are unaware of their hypertensive status due to factors that bother on poor management and poor screening approaches. The implication is that people who have poor access to healthcare especially those in the rural communities are at increased risk of cardiovascular complications and all-cause mortality. Unfortunately, not much has been done to ascertain the burden of undiagnosed hypertension and associated risk factors in rural communities in Nigeria. Methods: We conducted a community-based cross-sectional study in a rural community in Imo State, Nigeria, on burden of undiagnosed hypertension with participants recruited via a multi-stage sampling method. An interviewer-administered questionnaire was used, and standardized instruments were applied to obtain, process and analyze the data. Tests of association between the independent variables and outcome were conducted using logistic regression. P-value of Results: A total of 380 adults participated in the study. The mean age was 44.2 years. The prevalence of undiagnosed hypertension was 35.8%. Logistic regression revealed that age, with the respondents in the age groups 26 - 35 years (OR = 10.647, 1.910 - 59.345, p-value = 0.007), 36 - 45 (OR = 3.680, 1.263 - 10.723, p-value = 0.017), 46 - 55 years (OR = 2.737, 1.114 - 6.727, p-value = 0.039), 56 - 65 years old (OR = 3.384, 1.610 - 7.115, p-value = 0.001);and being married (OR = 3.846, 1.118 - 13.233, p-value = 0.033), were independent risk factors for undiagnosed hypertension. Conclusion: The prevalence of undiagnosed hypertension in the rural population of South-East Nigeria is high. Younger age (26 - 35 years) had the highest odds of risk for occurrence of hypertension. Also being married was identified as a risk factor for undiagnosed hypertension.

Nutritional and Clinical Profiles of Elderly People with Diabetes and Hypertension at Conakry University Hospitals

Introduction: In Guinea, there is few data on dietary practices socio-economic and clinical characteristics of elderly diabetics and hypertensives. Methods: This was a descriptive cross-sectional study of people aged 60 years and over, seen in consultation or hospitalised in Conakry University hospitals during the period from 5 September to 15 December 2023 inclusively. Results: Among the 320 subjects included in the study, there were more men (50.6%). The average age was 67 ± 7.69 years;53.43% had hypertension and 46.57% had diabetes. Sex was significantly associated with diabetes (p = 0.035). Women in the study were more affected by diabetes (55.7%), 64.4% of diabetic subjects were married and more than 64% of them had dependent children. 26.2% of diabetics were not employed;85.9% had an income;34.9% had an income of less than one million Guinean francs per month and 74.5% of them had 3 meals a day. Physical activity, 24-hour recall for lunch (p Conclusion: Effective management of diabetes and hypertension in the elderly should necessarily involve nutrition education in hospitals.

Dry eye rate and its relationship with disease stage in patients with primary hypertension:a cross-sectional study in Vietnam

AIM:To determine the dry eye(DE)rate and its relationship with disease stage in patients with primary hypertension.METHODS:A cross-sectional study included 432 patients with primary hypertension(with an equal number of patients in each group:144 in stage Ⅰ,Ⅱ,and Ⅲ hypertension)and 144 healthy subjects as a control group.The Ocular Surface Disease Index(OSDI)and Schirmer Ⅰ test without anesthetics were conducted on all 576 subjects.Subjects with OSDI scores<13 and Schirmer Ⅰ values equal to or under 10 mm were diagnosed with DE.RESULTS:The ratio of DE in hypertension patients was higher than in the control group(41.7%versus 18.8%;P<0.001).The proportion of patients with DE increased gradually according to the hypertension stage:27.1% in stage Ⅰ,40.3% in stage Ⅱ,and 57.6% in stage Ⅲ,P<0.001.Age,duration of hypertension,plasma urea,creatinine,and high-sensitivity C-reactive protein(CRP-hs)levels in hypertension patients with DE were higher than those without DE,P<0.001.Advanced age,a long duration of hypertension,diabetes mellitus,elevated plasma creatinine,and CRP-hs levels were independent factors associated with DE in primary hypertension patients,P<0.001.CONCLUSION:DE is a common disorder associated with advanced age,a long duration of hypertension,diabetes mellitus,elevated plasma CRP-hs,and creatinine levels in patients with primary hypertension.

Periodontitis exacerbates pulmonary hypertension by promoting IFNγ^(+)T cell infiltration in mice

Uncovering the risk factors of pulmonary hypertension and its mechanisms is crucial for the prevention and treatment of the disease.In the current study,we showed that experimental periodontitis,which was established by ligation of molars followed by orally smearing subgingival plaques from patients with periodontitis,exacerbated hypoxia-induced pulmonary hypertension in mice.Mechanistically,periodontitis dysregulated the pulmonary microbiota by promoting ectopic colonization and enrichment of oral bacteria in the lungs,contributing to pulmonary infiltration of interferon gamma positive(IFNγ^(+))T cells and aggravating the progression of pulmonary hypertension.In addition,we identified Prevotella zoogleoformans as the critical periodontitis-associated bacterium driving the exacerbation of pulmonary hypertension by periodontitis,and the exacerbation was potently ameliorated by both cervical lymph node excision and IFNγneutralizing antibodies.Our study suggests a proof of concept that the combined prevention and treatment of periodontitis and pulmonary hypertension are necessary.

Prevalence and Factors Associated with Hypertension among People Living with HIV Receiving Care in Three Large HIV Clinics in Nasarawa State, Nigeria

In the last decade, the long-term survival among people living with HIV (PLHIV) has significantly improved. This is accompanied by an increased burden of non-communicable diseases such as hypertension due to the combined effect of the aging population and the metabolic effect of the Human Immuno-deficiency Virus (HIV) virion and antiretroviral therapy. This study aims to assess the prevalence and factors associated with hypertension among people living with HIV in three large health facilities in Nasarawa State, Nigeria. A descriptive cross-sectional study employed a multistage sampling technique to select 309 adults with HIV, 18 years and above, receiving HIV care in three large health facilities in Nasarawa State. The outcome variable was the participants’ self-reported history of hypertension, confirmed through a positive history of hypertension treatment. Exposure variables included the participant’s socio-demographic characteristics, lifestyle factors, and HIV care and treatment history. Data were presented using frequency tables. Factors associated with hypertension were assessed using binary logistic regression at a 0.05 level of statistical significance. A total of 309 adults living with HIV were sampled. A larger percentage of the participants were married 228 (73.8%), female, 191 (61.8%), within the age group 41 - 50 years, 141 (45.6%). Most of the participants had no family history of hypertension, 188 (60.8%). The prevalence of self-reported hypertension was 11.0% (34/309). Factors associated with hypertension at the bivariate level were age group 21 - 30 years, 41 - 50 years, being widow/widower, divorced, retired from employment or with family history of hypertension. Only participants age group 31 - 40 years [Adjusted Odd Ratio (AOR): 0.18, 95%CI: 0.04 - 0.91, p = 0.04] and family history of hypertension [(AOR): 83.44, 95%CI: 15.75 - 442.11, p < 0.01] were found to predict hypertension among the study participants after adjusting for confounders. In conclusion, Hypertension remains a public health issue among PLHIV. Factors associated with hypertension among PLHIV include age and family history of hypertension. Regular screening for hypertension, its appropriate treatment and optimal control are essential in PLHIV.

Extracorporeal membrane oxygenation as a bridging therapy for patients with thiamine deficiency-induced pulmonary arterial hypertension

Thiamine deficiency is characterized by a deficiency of thiamine(vitamin B1),lactic acidosis,pulmonary arterial hypertension(PAH),right-sided heart failure,and peripheral nerve damage.Thiamine deficiency is easily misdiagnosed and missed during clinical practice and is associated with death in severe cases.[1,2]Here we reported a patient who was admitted to the hospital with severe metabolic acidosis and pulmonary hypertension and finally diagnosed with thiamine deficiency by detecting plasma vitamin B1 levels.Since clinically obvious thiamine deficiency is rare,and cases of thiamine deficiency requiring extracorporeal membrane oxygenation(ECMO)treatment are rarer,we believe that our case will be helpful for emergency clinicians.

2023 Guideline for the management of hypertension in the elderly population in China

Preamble Hypertension is one of the most common chronic diseases and the primary risk factor for stroke,myocardial infarction and even cardiovascular death.More than half of the elderly population has high blood pressure.Elderly people are a unique group,and strategies for the prevention,diagnosis,evaluation,and treatment of hypertension in elderly individuals differ significantly from those in the general population.

Risk Stratification and Prognosis of Pulmonary Arterial Hypertension Associated with Congenital Heart Disease

Background:Current guidelines for managing pulmonary arterial hypertension(PAH)recommend a risk strati-fication approach.However,the applicability and accuracy of these strategies for PAH associated with congenital heart disease(PAH-CHD)require further validation.This study aims to validate the reliability and predictive accuracy of a simplified stratification strategy for PAH-CHD patients over a three-year follow-up.Additionally,new prognostic variables are identified and novel risk stratification methods are developed for assessing and managing PAH-CHD patients.Methods:This retrospective study included 126 PAH-CHD patients.Clinical and biochemical variables across risk groups were assessed using Kruskal-Wallis and Fisher’s exact tests.Indepen-dent risk factors were identified using ordered logistic regression,while Kaplan-Meier and Cox proportional hazards regression analyses evaluated their impact on all-cause mortality.A new stratification model for the PAH-CHD population was constructed based on these analyses.Results:Significant survival differences across stratified risk groups were observed(p<0.001),validating the effectiveness of the simplified risk stratification method in PAH-CHD patients.Prothrombin activity was a strong independent predictor of adverse outcomes of PAH-CHD patients(Hazard ratio 0.95,p<0.001,C-index 0.70).A model combining N-terminal pro-brain natriuretic peptide,prothrombin activity,albumin,and right atrial area achieved an area under the curve of 0.89 and a C-index of 0.85.Conclusions:The simplified risk stratification method is applicable to PAH-CHD patients.Prothrombin activity is a strong independent predictor of adverse outcomes.A comprehensive risk stratification approach,incorporating both established and novel biomarkers,enhances accessibility and offers predictive efficacy during follow-up for PAH-CHD patients,comparable to established models.

Adherence to Pharmacotherapy in Post-Menopausal Women with Hypertension or Metabolic Syndrome: Real World Experience

Background: Adherence to medications is dependent upon a variety of factors, including individual characteristics of the patient, interactions with health care providers, and medication complexity. Even though several studies were conducted to test intervention strategies, results are uncertain. Aim: The aim of the study is to assess if a tailored combined intervention strategy improves medication adherence in a large population of post-menopausal women affected by hypertension or metabolic syndrome. Methods: We enrolled 6833 patients aged 50 to 69 years, 85.7% with hypertension, and 14.3% with metabolic syndrome. A network between patients, general practitioners, and cardiologists was established. Interventions included education, adequate information to patients, a simplified scheme of treatment, and periodic adherence assessment. These were either delivered as healthcare provider supports or using modern technology. Medication adherence was estimated by the proportion of days covered for all classes of drugs after the index date. Results: Non-adherent hypertensive women were 297 (5%), and those with metabolic syndrome were 73 (7.4%) (p Conclusions: The rate of non-adherence in both settings of postmenopausal women was 7.7%, much lower than that described in the literature. This rate was increased in patients with metabolic syndrome;probably it is related to the complexity of the therapeutic scheme or to a poor consciousness of the disease. Therefore, implementing a tailored combined intervention can improve significantly patients’ adherence to medical therapy.

Variations, effectiveness and its associated factors of a nationwide web-based hypertension management training project in China: insights from a government-led campaign for 1.2 million lay health workers

OBJECTIVES To evaluate the effectiveness of a large-scale,web-based,in-service hypertension management training project among lay health workers(LHWs) at primary care health(PHC) settings in China,and to examine the factors contributing to the variations of effectiveness.METHODS We used data from a web-based national hypertension management training project implemented in 2018,it was designed to facilitate LHWs to learn,understand,and apply the relevant knowledge and skills in hypertension management through providing training courses by use of the web-based platform with unified standards.All LHWs were required to participate in the exams before and after training to acquire scores for the use of evaluating their performance of hypertension management knowledge.We first used descriptive analysis to present the variations of effectiveness in hypertension management knowledge among LHWs by important subgroups.Afterwards,we used multilevel logistic regression to examine the individual and regional factors contributing to the variations and quantify the magnitude of how these factors affected training effectiveness.RESULTS There were 1,208,610 LHWs who completed training and were certificated.Nationally,the scores of LHWs increased significantly from 62.87 ± 21.14 out of 100 in the pre-test to 88.30 ± 11.31 in the post-test by 25.43(95% confidence interval[CI]:25.40-25.47).Training contents involved in antihypertensive medication showed the lowest score(54.36) in the pre-test and soared the most after training,up to 84.22 by 54.94%.Individual factors associated with disparities in the knowledge of hypertension management decreased substantially after training,which included sex,age,education,practice type,professional level,and hierarchy of working institutions.Geographical variations were shown at the provincial level,with the majority of them being explained by factors at the regional level.CONCLUSIONS Accessible web-based training modality,government efforts,accompanied with experiences derived from the training,could be generalized to other low-and middle-income countries in facilitating the hypertension management capacity of LHWs.Localization and evaluation is warranted on the way to its further application.

Literature Review of the Prevalence of Hypertension at Gulu University, Gulu City, Acholi Subregion, Northern Uganda

Hypertension is a big problem worldwide. The purpose of this study is to examine the prevalence, knowledge, attitude, and practice about hypertension at Gulu University, Gulu city, Gulu district, Acholi subregion, Northern Uganda. A literature search on hypertension was done. It showed that, in Uganda, a representative number of 17,777 adult patients’ data were analyzed from January 2014 to February 2024. The epidemiological data on awareness of hypertension was found to be at 8%. Of this, 18.3% of the people with hypertension had it under control. The results of the findings were promising. Hypertension is an important public health challenge in Uganda particularly in Northern Uganda where Gulu University falls. In comparison with the two regions of Central Uganda and Northern Uganda, there was a significant number of populations that were not aware of their condition. Those diagnosed were on treatment but the treatment was not adhered to due to stock outs of medicines. Therefore, Measures are required to prevent hypertension, improve awareness, treatment and control within the community, especially at Gulu University where research has never been done.

Prevalence, Awareness and Risk Factors for Hypertension in Adults Attending a Tertiary Hospital in South-East Nigeria

Hypertension, a non-communicable disease, is considered a major public health challenge because of its widespread prevalence globally coupled with its huge morbidity and mortality burden, which is largely preventable if early detection and prompt initiation of management are done. Hypertension prevalence is increasing especially in the developing world, despite this, its awareness among the general population is low. This study aimed at determining the prevalence of hypertension among adult attendees of the General Outpatient Clinic of the Federal University Teaching Hospital (FUTH), Owerri, with an assessment of the proportion of hypertensives who were aware of their hypertensive status, and identifying risk factors of hypertension in the study participants. A cross-sectional analytical study was conducted between October and November 2022 at the General Outpatient Clinic of the FUTH, Owerri. A total of 257 consenting and eligible adult patients made up of 135 males and 122 females, aged 18 years and above, were selected by systematic random sampling method. The overall prevalence of hypertension was 34.6%. The prevalence was higher in females than in males (37.7% vs 31.9%, P = 0.325). Among the hypertensive subjects 56.2% had awareness of their hypertensive status. Following a multiple regression analysis, hypertension was independently associated with age, family history of hypertension, occupation (retirees, traders, farmers and the unemployed), and marital status (being widowed). Hypertension is prevalent in our environment;the prevalence rate from this study is higher than in most studies in our environment, suggesting possibly, a rising burden. The results from the study underscore the need for increased and sustained advocacy for implementation of policies and programs directed at increased detection and management of hypertension in the different population groups such as annual wellness check for employees in the formal sector, largescale dietary and lifestyle adjustments, and know your numbers (an approach to population driven blood pressure check for all adults). Also, health workers should use any opportunity of contact with a patient to screen for hypertension.

Identification and Validation of Vascular-Associated Biomarkers for the Prognosis and Potential Pathogenesis of Hypertension Using Comprehensive Bioinformatics Methods

Background: Hypertension, also known as increased blood pressure, is a phenomenon in which blood flows in blood vessels and causes persistently higher-than-normal pressure on the vessel wall. The identification of novel prognostic and pathogenesis biomarkers plays a key role in the management of hypertension. Methods: The GSE7483 and GSE75815 datasets from the gene expression omnibus (GEO) database were used to identify the genes associated with hypertension that were differentially expressed genes (DEGs). The functional role of the DEGs was elucidated by gene body (GO) enrichment analysis. In addition, we performed an immune infiltration assay and GSEA on the DEGs of hypertensive patients and verified the expression of novel DEGs in the blood of hypertensive patients by RT-qPCR. Results: A total of 267 DEGs were identified from the GEO database. GO analysis revealed that these genes were associated mainly with biological processes such as fibroblast proliferation, cell structural organization, extracellular matrix organization, vasculature development regulation, and angiogenesis. We identified five possible biomarkers, Ecm1, Sparc, Sphk1, Thbsl, and Mecp2, which correlate with vascular development and angiogenesis characteristic of hypertension by bioinformatics, and explored the clinical expression levels of these genes by RT-qPCR, and found that Sparc, Sphk1, and Thbs1 showed significant up-regulation, in agreement with the results of the bioinformatics analysis. Conclusion: Our study suggested that Sparc, Sphk1 and Thbs1 may be potential novel biomarkers for the diagnosis, treatment and prognosis of hypertension and that they are involved in the regulation of vascular development and angiogenesis in hypertension.

Prevalence of Diabetes and Hypertension on World Diabetes Day 2022 in Guinea

Introduction: Diabetes mellitus and hypertension are chronic diseases that are on the rise and pose a major public health problem among the priorities of healthcare systems. Objectives: Determine the prevalence of diabetes and hypertension and describe the sociodemographic characteristics of those screened. Materials and Methods: This was a cross-sectional study organized during a diabetes and hypertension screening campaign that took place in Conakry and five (05) inland regions on November 14, 2022. Results: 2050 people were screened, of whom 33.12% were housewives, the average age was 44.78 ± 16.23 years, and 55.27% were women. The screening sites were the city of Conakry 741 (36.15%), the Labé region 424 (20.68%), the N’Zérékoré region 298 (14.54%), the Faranah region 241 (11.75%), the Mamou region 210 (10.24%) and the Boké region 136 (6.63%). The prevalence of diabetes and hypertension were respectively 12.5% and 43.38% for the Boké region;6.19% and 16.19% for the Mamou region;3.02% and 21.81% for the N’Zérékoré region;31.95% and 13.69% for the Faranah region;9.67% and 20.28% for the Labé region;2.83% and 20.28% for the city of Conakry. Conclusion: Despite the limitations of the study duration, our series highlighted the high prevalence of diabetes and hypertension among people screened on World Diabetes Day 2022. Raising public awareness of a healthy lifestyle is essential for the prevention and control of diabetes and hypertension.